Waiting room

All along the walls were metal stretchers separated by curtains that were pulled back. The nurses station situated in the middle was full of medical students and residents either sitting and talking or doing paperwork. On the other side of the room there are a few beds with a small mattress atop a board frame. Each bed is full and each each stretcher housed one and sometimes two patents. It is so crowded, people are waiting in line for a bed or stretcher in this emergency room. As I walk in I pass patients holding X-rays waiting to be read, a row of patients sitting in chairs waiting for a bed, some with hands or feet wrapped in bandages soaked in blood. Several look like they had been beat up with swollen faces, some are lying in pools of blood waiting for stitches. I couldn't help but wonder why in the world all the students and residents were standing around with so much that needed to be done! One resident pulls me over to a bed and pulls out the patients CT scan and shows me a large subdural hematoma. This poor kid was just lying there with an NG tube. The resident explained he was waiting on the neurosurgery attending to get here so they could evacuate the bleed. Then he shows me a lady in the line for a bed who's CT shows a ruptured aneurysm. How she was still sitting there I have no idea! We found out that all these patients were waiting for surgery. I was in the surgical ER and the place was so overwhelmed by patients that emergencies were waiting in line for a bed to wait in line for an OR to operate.

I then walk back to the orthopedic section where I met the orthopedist who eagerly shows us how to apply casts. He then turned over the casting to us and only showed us who needed which cast and then left. One lady had almost chopped her thumb off and was there to get it cleaned and hopefully sown back together. As the student cleaned her wound I could tell that part of her thumb had already begun to die and there's no way we could save it. We didn't get to her fast enough and now she would have to have part of her thumb removed. Then these parents bring their son to us on a metal stretcher. He had been in a motorcycle accident and his arm looked like it had 2 wrists. It was an open fracture so we had to clean the area very well and then we casted it so he could be admitted to the hospital for antibiotics for a few days before doing the surgery to fix it. He laid in the hallway after we finished for several hours with his family standing there, until they were told where they could take him next. No nurse or hospital staff is wasted moving patients. The families or friends must move them from line to line or room to room. I often saw people alone on stretchers in the hall waiting for someone to move them. 

We casted just about everything. Apparently the only resource here is plaster. Very few ace wraps, and no knee sleeves or ankle braces. We casted ankle sprains, knee sprains, and then of course the broken ones too. I watched the ortho resident pop a displaced tibial fracture back into place, and then another resident try and fail to re-approximate a displaced distal radial and humerus fracture. It's just a different world here. Use what you have to help people as fast as you can and get them out so we can keep the line moving. One guy couldn't afford the material to fix his leg (patients must go buy part of the materials because the hospital runs out quickly) so we just sent him home so we could reuse that bed. And if a patient needed stitches, it was done as fast as possible with as few stitches as possible. Forget all the techniques to minimize scarring. That is a luxury. 

If you walk out of the ER you will find a long hallway outside of X-ray which has been overflowing with people each time I have walked it. Everyone is waiting for an X-ray to go wait to have it read . . . It seems so wrong. And yet has I have sat and considered these things each day I've noticed they really are doing the best they can. There's just too many people for so few resources. And it works, it's not the best but it gets the job done and helps the most people possible given the conditions. 

But I can't help but be so thankful for the way God made our bodies! He made us perfect and then sin wrecked havoc and now bones get broken and motorcycles wreck. But His grace is so great that He still gives us a way to heal. I mean all we have to do is line up the broken bone together and it repairs itself! We just have to hold the skin closed long enough for it to replace the hole with new skin! Grace is in the details we often look over. How much harder it would be if our bones didn't heal or our skin was left with a hole! 

You know it even reminds me of us as the body of Christ. We have been healed but the world around us is so broken and is bleeding and waiting to find the right 'cure' for their ailments. We have the Way to bring healing! The Only Way! And it doesn't have to be perfect on our part! We don't have to have the perfect words or illustration. Yes God asks us to be faithful and be there to apply a 'cast' or a 'stitch' but those things don't heal, God does! And yes, the harvest is plentiful but the workers are so few!    Who is it that God has placed around you or me that is waiting to be healed? 

Hope in the midst of pain

January 21

I sat across the room from her talking in broken Spanglish with other medical students and the doctors. She was another young mother here to deliver and like most of the women in this room she wailed in pain with each contraction and even cried out 'doctor, doctor!' As our conversation eased, I again heard her cry and felt the urge to go sit beside her and try any seemingly small measure to bring comfort, but I hesitated because I knew it would be difficult to converse with my very limited Spanish. There was just enough room for me to sit between her and the next laboring mother. I tried to ask in Spanish her baby's name which she told me, then she said in perfect English, "it hurts really bad". Woah, she's speaks English! This began a long discourse where I do believe we became friends. 

22 year old Hope was in college as a marketing major when she became pregnant. Apparently this caused many problems in her family and even caused her to stop going to church because as she said, "I am so much a disappointment". Her contractions became greater, longer, and more frequent, and each time she would hold her breath and squeeze my hand. Then apologize for squeezing so hard. She kept saying I am never having children again, I just want a c-section! I tried explaining that really wasn't best for her body and it would be good if we didn't have to. But the pain she felt at the moment was all she could see, along with the disappointment she was to her family. I asked to pray with her and we bowed our heads. I didn't ask God to take the pain away, but that He would help her through it, and that He would bless her and her son. That's when she asked if I was a Christian. And from there she told me her story, and the weight she bares. A smile crept across my face as I explained to her why Jesus is so good. He knows we mess up and He knows we aren't perfect, but He still offers forgiveness if we ask. He offers healing, wholeness. And even when we mess up, He can make it into something beautiful like a precious baby boy. Who knows what God has in store for him! God didn't make a mistake creating him or choosing her as his mother or even choosing the timing of his birth! Jesus came for people like us, people who mess up and need to be forgiven. The weight she bares can only be lifted by the God who who already bore it. Her sin engulfed her with physical and emotional pain as literally the consequence of her specific sin, and yet also literally as the consequence of her sin nature. But thanks be to God who has defeated sin, and made a way to be forgiven! 

Just as we finished this conversation, the Doctora whisked me away because a baby was crowning and I was next in line to deliver. As I stood up, Hope made me promise to come back to her bedside. The Doctora was so helpful to urgently yet gently show me the way through my first live delivery. The poor mother had a rough time. I don't think I'll ever forget the Spanish words for Come on, push! "Siga, Siga, Siga, Puje!" The actually delivery was easier than I expected, at least my part that is. It is an absolutely amazing thing that takes place with that first breath of air for a baby. As I held her tightly in my palm and cleaned her off I couldn't help but take a moment to marvel in the miracle taking place! In that moment her circulatory process was almost completely reversing. For the first time her lungs were full of air and blood coursed through through them to fuel up. I watched her fists clinch and then open almost as if she welcomed the space to move more freely. I must have taken too long, because Doctora had the cord clamped and ready to cut before I realized it. I cut the cord and laid the baby down. It was this moment that helped solidify my desire to go into pediatrics. I didn't want to leave the baby! 

But I finished helping the mother and back we went to the labor room where still more mothers waited. Soon after I sat back down beside Hope, the OB came in to round on the women. He noticed Hope had stopped progressing in labor but still was not far enough along to deliver. So he decided she needed a c-section. She was relieved, but quietly asked me to please make the cut and repair carefully so the scar wouldn't be too big. She had a rather large abdominal scar already 5 inches in length and almost 1 inch in width from an appendectomy a few years prior. She was very embarrassed about it and didn't even really want us looking at it. She then grasped my arm and said, "you're so white"! "Haha, yes I am," I chuckled. "And you don't mind that my skin is dark?" I was taken aback by her question. Really, could she be serious? My heart broke that the question even came to her mind. 

I went with her to the operating room and talked with her as I held her hand still. I watched as her baby boy was born and she was able to see him for the first time. Finally a smile appeared on her face! The OB must have noticed the embarrassment she had of her scare because instead of the typical incision, he chose to use the previous incision made and in so doing he will have given her a much nicer looking scar. So now that place will no longer be a shame to her but rather a reminder of the day her son was born! I didn't get to see her after the surgery, and I know she is still trying to bare the weight of her sin alone. All I can do now is ask God to continue to show Himself to her. To open her eyes to who He is that she would repent and find forgiveness in Him. I pray that her son would not be a reminder of her sin, but rather of God's Redeeming grace! God sent us to meet each other last night, and I pray it has an impact on eternity!

"You shall bear children in aguish" Gen 3:16

First night in labor and delivery

Well I had my first over night 12 hour shift last Wednesday night. I was nervous mostly because I didn't know how my body would hold up. We arrived at the hospital a little after 7, and were taken to a room with 8 beds against 2 walls. Several beds were already occupied by mothers in labor. Their were also several Honduran medical students who really acted like residents. The physician came in and we rounded on those who were there. Trying to determine who was ready to deliver and who, if any, needed surgery. It didn't take long before the first was whisked to the delivery room. One student was gowned up and ready to go. Now, as I have never delivered or even actually seen a live birth, This was quite fascinating! I am still in awe of how God created the womb, but more in awe of all the changes that take place with that first breath! Buts that's for another time. My extremely limited Spanish did hinder some of what I could do, and really hindered what I could learn as the doctor taught the students. However, a few students knew English and were so helpful to relay the important information to me. One student in particular took the time to talk me through a delivery and also teach me many techniques to measure important information without the high tech machines we use in the States. He made sure we knew what was going on and got in on the c sections etc. 

As I was sitting in the labor room, listening to the shouts of women in labor pains, I could not help but be reminded of the curse of sin. There it was as loudly as I had ever heard. And yet even so it was not nearly the worst consequence of sin! Not only do we labor in pain, but we are separated from the God who made us. All I could provide in that moment was love, a hand to squeeze or a pat or rub on the shoulder. She had to bare this pain herself, but oh praise be to God that we do not have to bare the weight of sin ourselves! That is the good that comes from the suffering of labor. It is an amazing reminder of the curse of sin and our need of a Savior! Please pray with me that though there is a language barrier and though these women are in much pain and don't necessarily want to chat, pray that that the Holy Spirit would show me how I can shine. Even if it is a hand to hold or my presence at a bed side so she knows she is not alone. Tonight I head back for my second shift in Labor and delivery. Although I am praying hard that my feet don't wear out and I can stay alert all night I am also praying for the women and students there. That even though I will be tired, and there will be a language barrier, that God would shine!

Whispers of Wisdom

Well I made it to Honduras. One day late, but I didn't miss much. We bought some groceries and then settled into our apartment for the month. My last visit here I was surprised to find that Baxter provided internet services for those staying here, as well as the clinic I was working in. So this was my fist international trip where I expected to have some form of communication with those back home. Well when I arrived I found out neither of those internet services were working, and even now as I type (1-15-15) it is in hopes that eventually I will be able to post this online sometime later. Communication has always been the hardest part for me on these trips. I want to know that I can reach people if I need to, and honestly I just like to keep in touch with people back home if possible. Maybe this is a product of my generation? Or maybe it's sin . . . Trying to have and maintain some form of control?

Before I left the states, my pastor preached a sermon on James 1. "Consider it all joy my brethren when you fall into various trials" "now if any of you lacks wisdom, he should ask God who gives to all generously and without criticizing, and it will be given to him. But let him ask in faith without doubting. For the doubter is like the surging sea, driven and tossed by the wind." As my pastor says, everyone is in 1 of 3 groups. You are either in a trail right now, you just came out of a trial or you are headed for a trial. Well I figured I was probably headed for one, and though the internet being out is not really a great trial, I am trying to apply the same principles to even the small stuff.

You see, God has promised us that all things work together for our good. He refines and purifies us as a silversmith refines silver. And He uses trials to do just that. Unfortunately, there is no better medium than fire to cleanse impurities, and that applies to our hearts too! So what James is reminding us here in chapter 1 is that there is wisdom to be gained when going through trials, and it is a joy to gain it. Of course we lack the wisdom in the first place, that is why God allows trials. So when we lack wisdom and God is allowing a trial, we should focus on looking to God for that wisdom, or the purification He wants to bring from it. But we must ask Him believing that He will grant it, and that there is a purpose for the hard time we are enduring. It's not about getting through the rough times as fast as possible, its about growing through it. God will end our suffering when and if He chooses. Our concern should be what is God trying to show me or trying to perfect in me. We should focus on not missing the blessing in the midst of the storm.

So why, you may ask, is having no internet a trial for me? This is my 8th international trip. With each trip I was prepared to have zero or limited communication with people in the States. For this trip however, I was not prepared. All I could think when I arrived was how mom was worrying because I couldn't let her know I had made it safely. It goes back to one of my biggest fears. I never want to cause anyone else pain or in this case worry (I do realize that with the career path God has chosen for me I will have to cause some pain, but it is for the greater good. . .kind of like how God deals with us . . .). So yes, the thought of mom anxiously waiting to hear from me for 2 days got to me. As I prayed about it that Still Small Voice whispered "Am I not more reliable than the internet"? Ouch! yes, Lord! What I really want for my family is peace, and who am I to think that I can bring it by using the internet more so than God can bring them peace without it! My God is a God of peace, and He brings comfort, better than anything else!

So, as we see, God always speaks in the storm, no matter how big or small it may seem. The key is to listen, expecting Him in the Still Small Voice. 

 

Detour

I can picture us sitting in the see-saw contemplating ways that we would never have to part and our friendship could last forever. I don't know who came up with it first, but hey I have a little brother and you have a little sister! Let's marry them! Then we will officially be sisters and can always be together! So what do we do? We grab both of them and marry them then and there, both of us acting as the pastor of course. But our little scheme didn't work. Her family still moved to GA. The year was 1997. These almost 20 years since I've never quite found a friend that is so much like me. Same sporty, outdoorsy, I'm going to play with the guys because they're cooler, attitude. We would hide under pews at church or anything else so we didn't have to go home, and once she even buried her shoe in the playground so we would have to stay and 'look' for it! 

Flash forward to yesterday. I finally left for a rotation in Honduras which I was so incredibly excited about! I knew I only had 30 mins to change flights in Atlanta but I had my running shoes on and was ready to get there as fast as I could. Then we sat on the runway for 30 mins, there goes my time to change flights. We touched down and my next flight was boarding, they closed the doors as I was running to get there. No one was at the desk but I could see the plane sitting there still! I missed it. Yet, I was 't as stressed or worked up as I had expected I would be. As my plane was taxiing to the gate I prayed Lord whatever happens, please let me be calm and not rude, not to anyone. And He did, He calmed my spirit, and reminded me that He made me miss that flight and I needed to now look for what He wanted to show me. I went to a local hotel and had about 20 hours until my new flight. It was tempting to just turn on the TV and let time waste away. After all I was just waiting for the next day right? But I couldn't do that. I knew God arrange this and I needed to be still and listen. So, I turned on the praise music and opened my bible. 

"Who is a God like you, removing iniquity and passing over rebellion for the remnant of His inheritance? He does not hold onto His anger forever, because He delights in faithful love." Micah 7:18

"Yahweh, your God is among you, a victorious warrior, He will rejoice over you with gladness. He will bring you quietness with His love. He will delight in you with shouts of joy." Zephaniah 3:17

As I began writing in my journal I realized that I had been so focused on Gods works, His creation, His biggness. I had forgotten to bask in His love. I tend so easily to come to God has a Father who disciplines and who deserves more of me than I can give. And I forget that I don't have to be perfect, He loves me as I am. I don't have to muster up, well, anything. 2 Peter tells us that He has given us everything for life and godliness, through the knowledge of Him. This God, the one who created the world in so much intricate detail that we cannot comprehend it, He removed my iniquity and passed over my rebellion, He is my inheritance, He is my victorious warrior, and He brings me quietness. But here's the kicker, this God, He delights in me with shouts of joy! God caused me to miss that plane to remind me that I don't have to focused on doing everything for Him to the best of my abilities, I need to focus on Him! 

And isn't it just like God to give blessing after blessing, my friend who moved to Ga, she was able to come meet me at my hotel. And we picked up right where we left off! God is making her into an incredible woman, wife and soon to be mother! And what an encouragement to just be able to talk with her and laugh and remember. 

God is so good, and His ways really are higher! So now, I'm back at the airport sitting at my gate, more prepared to serve Him, to bask in Him, in Honduras! 

Ding, Light Bulb!

That light bulb moment. Almost like a Gibb’s slap from behind makes everything come into view and all the sudden your little puzzle piece fits into a masterpiece of a picture that you never imagined. That was me last night.

God has made me a very passionate person. Throughout growing up whatever that latest thing was I would run after it hard, until something else came up. I was in band, I played basketball, I taught drum lessons, I taught Sunday school, helped a church plant, helped Invisible Children, went on every mission trip my parents would allow, and of course cheered for the Lady Vols like it was going out of style.

In college it became a problem, because having so many things to be passionate about makes it hard to choose what to do with the rest of your life. There for a while I thought I had it figured out. Teach middle school science and math and do athletic training on the side. This combined my passion of sports, with teaching and my unusual passion to work with adolescents who most people would rather run from. Then I started working with refugees and again yet another passion emerged. Few things in my life have been as fulfilling as helping those Muslim mothers and their families adjust to living in Knoxville! When I felt God call me to go to medical school, I battled Him hard. Somewhat because of the amount of work He was asking of me, but also because going to medical school meant giving up all of these passions I so loved, at least for a time.

I obeyed and went to med school trusting that it would become a passion of mine. God used those precious women with veiled face to take me there. Again, I assumed that the best fit for my medical specialty would be family medicine, because I could work with, well, everyone. The women, their kids and I guess their husbands too. This would be ‘most useful’ overseas of course.

But then here I was in my 3^rd year of school. I had 4 weeks of family medicine and well I didn’t really like it. But maybe it was just the doctor I was working with or that I’m not overseas yet. I mean surely I’ll enjoy it in the right setting? Right? I found myself floating through 2 more primary care rotations and I started getting a little scared. God, really, is THIS what you brought me here for? Because I expected it to be, well, a little more satisfying. I started questioning does He really want me overseas, because if so I should go to this residency and do this, this and this, but if I’m staying in the US, I’d rather do this, this and this. And if I’m going to get married I need to only pick from these things for residency, but wait, what if God doesn’t want me to get married? Then I could do this or this.

Round and around it went in my head and I was getting very dizzy! Not to mention VCOM just had their residency fair where you can meet and talk to directors and start thinking about where you want to go. I walked away from that just as confused as ever. The only good thing was that I was able to talk to a resident in OBGYN (which I was highly considering) and realized how much surgery is involved. I really only wanted to deliver the babies, I’m not a surgeon of any sort! So, at least I could basically mark one thing off my list.

To make matters worse, my radar had consisted of Family med, internal med, and OBGYN (which we can mark off now), but I am in my pediatrics rotation, and it is WAY TOO FUN!!!! I don’t really like kids, because when they start crying I have no idea what to do with them. Not to mention I have issues with kids with behavior problems and I just want to tie them down. But for the most part these are not issues in the pediatric office. I’m not responsible for their behavior in the office, so it makes them much more enjoyable! So now, pediatrics was maybe sort of on my radar, but I wasn’t quite ready to admit it. Honestly, the thought of me as a pediatrician makes me laugh . . . pretty hard!

Then last night I’m talking to my preceptor about how I’m doing in this rotation and what I can improve on and such. Just out of curiosity I ask her about residencies as if I was considering peds. She goes into a few residency programs and mentions there are several fellowships, adolescent medicine being one of them. Adolescent Medicine, there it was. The Gibb’s slap. Why this never occurred to me before, I have no idea. Not only can I minister to families as I get to know them, but I can work with that age group that too often gets pushed to the side because no one wants to deal with ‘hormones’ and whatever else makes them crazy at that age. I can do missions through this, I can do sport medicine through this, and I can revive my passion for this age group!

Ladies and gentlemen, it looks like I might be a pediatrician. For those of you who know me, you may laugh this once, but I’m serious. I am so thankful that God knew all of this so long ago and has been shaping me for it for quite some time. It’s a great feeling, and I am so excited to study medicine again!  

Transition to 'student doctor'

I walk into a room for about the 6^th time that day with my notes scribbled about what disease processes to inquire of for this person. I was surprised to see a middle-aged downs syndrome woman and her elderly mother sitting quietly waiting on me. I went through my usual talk tailored to her specific health needs, but our conversation kept coming back to how God miraculously saved this woman’s life while battling pneumonia early that year. I could’ve talked to these two precious ladies all day! But I struggled in my heart to not waste the time of my next patient who was already waiting on me, not to mention the physician who was waiting on my report of this woman. What a blessing it was to slow down and celebrate with this family how God showed Himself powerful on their behalf. My fellow sister in Christ and I sat and praised Him for His sovereignty and goodness, then out the door I had to go. After about a 45 minute visit, all I had to report to my attending was that she was doing well and had no complaints today. He gave that look like why did you spend so much time in there then, but I just moved on to ask him about our next patient.

I can honestly say that the 3^rd year of medical school is so much better than the first 2! Very little studying and actually talking to patients! But, there is still this uneasiness about me regarding that which is required of me now, and this new schedule I must take on. I am still getting used to working everyday like a real person, but loving the less time studying and more time with people!  There for a while I was a little frustrated with myself, but I felt like I was just surviving and nothing else. I tend to revert back to that any time there is a big change in my life. Like no more sitting in a classroom and studying my life away anymore. But, that was one of the biggest lessons God taught me a while ago in a place called Malawi. He never intends for us to just survive. We know God has a purpose for each of us and if we are His that purpose is for our good and His glory. But where does that start or stop? Can I really just live my life how I want and know God will use me to accomplish this purpose sometime in the future without any effort on my part? I don’t think so. But rather when I am every day in His will, abiding in Him, He is accomplishing that purpose through me every day. This promise is to those who love God and are called according to His purpose. So how do we love God? By keeping His commandments (John 14:15). So through obedience (ie love) we have this promise of a life of purpose, not survival.

But even in medical school? I mean wouldn’t surviving medical school be enough? Not for a Christian, whose life purpose is God’s glory! What a shame it would be to survive medical school and miss all the lessons God wanted to teach you about Himself, all the students, faculty, ect that He wanted to use you to touch. Anyway, the point is that even while I am transitioning into the clinical phase of my education, my aim is still His glory over my education. And for the first few weeks I haven’t been living up to that. So I had to make a conscience effort to put Him first every day.  This has put so much life into each day. I don’t have to wear a shirt with Jesus across the front of it, or turn every conversation to Him. But, I have found that abiding in Him makes the difference. All I have to do is listen, care, and be attentive to the HS leading me. I have prayed with only 1 patient thus far, but I have been amazed by the amount of patients, like the lady mentioned earlier, who would open up to me. I could sit and watch the aroma of Christ change their demeanor. Even patients I was warned were normally grumpy and ‘suck the life out of you’ would melt under the love of Christ, and my attending would come back to me and say ‘wow, he’s in a good mood today.’ I have loved watching God shine!

I must be honest, I don’t live up to this every day, but I can tell you when God’s grace brings me back where I should be nothing else matters! So here I am 8 weeks into my 3^rd year and still facing this same battle each day. A battle that began as a junior in college. But God is so faithful as always, and I know He isn’t finished!

Clinically speaking, I have seen many cool things, but honestly have been a little bored with outpatient medicine. Maybe it’s just because I can’t really do everything yet, but I’m ready to do more and see some different diseases. I never thought I would enjoy working in a hospital, but I have my first shift on call at Norton Community Hospital this Thursday, so we shall see. I’m honestly much more excited than I thought I’d be. I’m ready to do and see some crazy stuff! Norton has some beautiful mountains, but man, I’m already so cold! I did find out a little while ago that I’ll be able to do 4 weeks in Honduras in January and February. I’m super excited about that for multiple reasons. I’ll get to deliver babies working in the local hospital as well as out in the village however, without an interpreter! I have a lot of Spanish to learn before then! Needless to say though, I am so incredibly thankful for what God has done and will do!